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Bozulmuş glukoz ve lipid metabolizması ve anormal karaciğer enzim düzeylerinin multipl akrokordonların oluşumundaki rolü: Bir olgu kontrol çalışması

Yıl 2020, Cilt: 3 Sayı: 2, 42 - 51, 30.06.2020
https://doi.org/10.33204/mucosa.736372

Öz

Amaç İyi huylu deri tümörlerinden olan akrokordonlar, gevşek fibröz dokunun protrüzyonlarıdır. Akrokordonların anormal lipid profili, diyabet, kardiyovasküler hastalık, obezite, anormal karaciğer enzimleri ve genetik faktörlerle ilişkili olduğu çeşitli çalışmalarda gösterilmiştir. Çalışmamızda multipl akrokordonların obezite, bozulmuş glukoz ve lipid metabolizması, tiroid hastalıkları, anemi ve karaciğer enzim anormallikleriyle arasındaki olası bağlantıları araştırmayı amaçladık.

Yöntem Çalışmamıza en az 8 adet skin tagı olan 65 hasta (32 erkek, 33 kadın) ve yaş ile cinsiyet uyumlu, skin tagı olmayan 60 kontrol olgusu dâhil edildi. Hastaların ve kontrol  grubunun yaş, boy, kilo, vücut kitle indeksi (VKİ) ve ayrıntılı medikal geçmişlerini not ettik. Hasta grubunda akrokordonların yerleşim yerleri kayıt edildi. Hastaların ve kontrol grubunun açlık plazma glukoz, insülin, insülin direnci düzeyi (HOMA-IR), total kolesterol, trigliserid, yüksek ağırlıklı lipoprotein (HDL), düşük ağırlıklı lipoprotein (LDL), serbest T3 (fT3), serbest T4 (fT4), tiroid stimulan hormon (TSH), hemoglobin, ferritin, vitamin B12, aspartat aminotransferaz (AST), alanin aminotransferaz (ALT), gamma glutamil transferaz (GGT), alkalen fosfataz (ALP) ölçümlerini kayıt ettik. 

Bulgular Çalışmamız sonucu multipl skin tag oluşumunda genetik eğilimin var olduğunu göstermektedir (P=0.0001). Hastaların ve kontrol grubunun ortalama VKİ değerleri arasında belirgin düzeyde anlamlılık mevcuttu (P<0.0001). Ek olarak, açlık plazma glukoz, AST ve GGT düzeylerindeki artışın multipl akrokordon oluşum olasılığını arttırdığını bulduk (sırasıyla P=0.048, P=0.003, P=0.013). VKİ’ndeki artışın her iki cinsiyet için de risk oluşturduğunu tespit ettik (sırasıyla P=0.003, P<0.0001). Ayrıca, açlık plazma glukoz, insülin, HOMA-IR, total kolesterol, trigliserid, AST, ALT ve GGT düzeylerindeki artışların kadın hasta grubunda multipl akrokordon oluşum olasılığını arttırdığını bulduk (sırasıyla P=0.037, P=0.022, P=0.013, P=0.03, P=0.007, P<0.0001, P=0.015, P=0.005).

Sonuç Çalışmamızın sonuçları multipl akrokordonların anormal glukoz ve lipid metabolizması ve karaciğer enzim anormalliklerinin deri bulgusu olabileceğini göstermektedir. Bu nedenle, klinisyenlerin multipl akrokordon şikayeti ile başvuran hastalardan uygun kan testlerini istemelerini ve onları buna uygun yönetmelerini öneriyoruz.

Destekleyen Kurum

yok

Kaynakça

  • 1. Rasi A, Soltani-Arabshahi R, Shahbazi N. Skin tag as a cutaneous marker for impaired carbohydrate metabolism: a case-control study. Int J Dermatol 2007;46:1155-9.
  • 2. Senel E, Salmanoglu M, Solmazgul E, Bercik Inal B. Acrochordons as a cutaneous sign of impaired carbohydrate metabolism, hyperlipidemia, liver enzyme abnormalities and hypertension: a case-control study. J Eur Acad Dermatol Venereol 2011.
  • 3. Crook M. Skin tags: a useful clinical sign for insulin resistance. Eur J Dermatol 2012;22:5-6.
  • 4. Idris S. Sunitha S. Assessment of BMI, serum leptin levels and lipid profile in patients with skin tags. J Clin Diagn Res 2014;8:1-3.
  • 5. Khaled M El-Zawahry, Mohamed A.R. Abdallah, Heba E Elmahdy. Study of the possible relationship between skin tags and obesity in Egypt. Egypt J Dermatol Venereol 2013; 33:18-21.
  • 6. Tripathy T, Singh BSTP, Kar BR. Association of skin tag with metabolic syndrome and its components: a case-control study from Eastern India. Indian Dermatol Online J 2019; 10:284-7. 7. Agarwal JK, Nigam PK. Acrochordon: a cutaneous sign of carbohydrate intolerance. Australas J Dermatol 1987;28:132-3.
  • 8. Sari R, Akman A, Alpsoy E, Balchi MK. The metabolic profile in patients with skin tags. Clin Exp Med 2010;10:193-7.
  • 9. Gracia Hidalgo L, Orozco-Topete R, Gonzalez-Barranco J, et al. Dermatoses in 156 obese adults. Obes Res 1999;7:299-302.
  • 10. El Safoury OS, Abdel Hay RM, Fawzy MM, et al. Skin tags, leptin, metabolic syndrome and change of the life style. Indian J Dermatol Venereol Leprol 2011;77:577-80.
  • 11. Demir S, Demir Y. Acrochordon and impaired carbohydrate metabolism. Acta Diabetol 2002;39:57-59.
  • 12. Saraiya A, Al-Shoha A, Brodell RT. Hyperinsulinemia associated with acanthosis nigricans, finger pebbles, acrochordons and the sign of Leser-Trelat. Endocr Pract 2013; 19:522-5.
  • 13. Sudy E, Urbina F, Maliqueo M, Sir T. Screening of glucose/insulin metabolic alterations in men with multiple skin tags on the neck. J Dtsch Dermatol Ges 2008;6:852-5.
  • 14. Erdogan BS, Aktan S, Rota S, Ergin S, Evliyaoğlu D. Skin tags and atherosclerotic risk factors. J Dermatol 2005;32:371-5.
  • 15. Tamega Ade A, Aranha AM, Guiotoku MM, et al. Association between skin tags and insulin resistance. An Bras Dermatol 2010;85:25-31.
  • 16. Gorpelioglu C, Erdal E, Ardicoglu Y, et al. Serum leptin, atherogenic lipids and glucose levels in patients with skin tags. Indian J Dermatol 2009;54:20-2.

The role of impaired glucose and lipid metabolism and liver enzyme abnormalities in the formation of multiple acrochordons: a case-control study

Yıl 2020, Cilt: 3 Sayı: 2, 42 - 51, 30.06.2020
https://doi.org/10.33204/mucosa.736372

Öz

Background Acrochordons, one of skin tumors, are protrusions of the loose fibrous tissue. In various studies, they have found to be associated with abnormal lipid profile, diabetes, cardiovascular disease, obesity, abnormal liver enzymes and genetic factors. In our case-control study, we aimed to determine possible associations of multiple acrochordons with obesity, impaired glucose and lipid metabolism, thyroid disorders, anemia and liver enzymes abnormalities.

Methods Sixty-five patients (32 male, 33 female) with at least 8 skin tags and age- and gender-matched 60 controls without skin tags (30 male, 30 female) were enrolled to the study. We noted patients’ and controls’ age, height, weight, body mass index (BMI) and detailed medical history. Locations of acrochordons were recorded for the patient group. We recorded values of fasting plasma glucose, insulin, homeostatic model assessment insulin resistance (HOMA-IR), total cholesterol, triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), free T3 (fT3), free T4 (fT4), thyroid-stimulating hormone (TSH), hemoglobin, ferritin, vitamin B12, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP).

Results Our study has shown a genetic predisposition to the development of multiple skin tags (P=0.0001). The mean BMI was statistically significant between the patients and controls (P<0.0001). In addition, we have found that when fasting plasma glucose, AST and GGT levels increase, the possibility of the forming of multiple acrochordons also increases (P=0.048, P=0.003, P=0.013). We determined that increasing of BMI is a risk factor for both genders (P=0.003, P<0.0001, respectively). We found that elevated fasting plasma glucose, insulin, HOMA-IR, total cholesterol, triglyceride, AST, ALT and GGT levels increase possibility of the forming of multiple acrochordons in females (P=0.037, P=0.022, P=0.013, P=0.03, P=0.007, P<0.0001, P=0.015, P=0.005, respectively).

Conclusion Our results show that multiple acrochordons may be the cutaneous signs of abnormal glucose and lipid metabolism and liver enzyme abnormalities. Thus, we suggest that clinicians should see appropriate bloodtests for patients with multiple skin tags and manage them accordingly. 

Kaynakça

  • 1. Rasi A, Soltani-Arabshahi R, Shahbazi N. Skin tag as a cutaneous marker for impaired carbohydrate metabolism: a case-control study. Int J Dermatol 2007;46:1155-9.
  • 2. Senel E, Salmanoglu M, Solmazgul E, Bercik Inal B. Acrochordons as a cutaneous sign of impaired carbohydrate metabolism, hyperlipidemia, liver enzyme abnormalities and hypertension: a case-control study. J Eur Acad Dermatol Venereol 2011.
  • 3. Crook M. Skin tags: a useful clinical sign for insulin resistance. Eur J Dermatol 2012;22:5-6.
  • 4. Idris S. Sunitha S. Assessment of BMI, serum leptin levels and lipid profile in patients with skin tags. J Clin Diagn Res 2014;8:1-3.
  • 5. Khaled M El-Zawahry, Mohamed A.R. Abdallah, Heba E Elmahdy. Study of the possible relationship between skin tags and obesity in Egypt. Egypt J Dermatol Venereol 2013; 33:18-21.
  • 6. Tripathy T, Singh BSTP, Kar BR. Association of skin tag with metabolic syndrome and its components: a case-control study from Eastern India. Indian Dermatol Online J 2019; 10:284-7. 7. Agarwal JK, Nigam PK. Acrochordon: a cutaneous sign of carbohydrate intolerance. Australas J Dermatol 1987;28:132-3.
  • 8. Sari R, Akman A, Alpsoy E, Balchi MK. The metabolic profile in patients with skin tags. Clin Exp Med 2010;10:193-7.
  • 9. Gracia Hidalgo L, Orozco-Topete R, Gonzalez-Barranco J, et al. Dermatoses in 156 obese adults. Obes Res 1999;7:299-302.
  • 10. El Safoury OS, Abdel Hay RM, Fawzy MM, et al. Skin tags, leptin, metabolic syndrome and change of the life style. Indian J Dermatol Venereol Leprol 2011;77:577-80.
  • 11. Demir S, Demir Y. Acrochordon and impaired carbohydrate metabolism. Acta Diabetol 2002;39:57-59.
  • 12. Saraiya A, Al-Shoha A, Brodell RT. Hyperinsulinemia associated with acanthosis nigricans, finger pebbles, acrochordons and the sign of Leser-Trelat. Endocr Pract 2013; 19:522-5.
  • 13. Sudy E, Urbina F, Maliqueo M, Sir T. Screening of glucose/insulin metabolic alterations in men with multiple skin tags on the neck. J Dtsch Dermatol Ges 2008;6:852-5.
  • 14. Erdogan BS, Aktan S, Rota S, Ergin S, Evliyaoğlu D. Skin tags and atherosclerotic risk factors. J Dermatol 2005;32:371-5.
  • 15. Tamega Ade A, Aranha AM, Guiotoku MM, et al. Association between skin tags and insulin resistance. An Bras Dermatol 2010;85:25-31.
  • 16. Gorpelioglu C, Erdal E, Ardicoglu Y, et al. Serum leptin, atherogenic lipids and glucose levels in patients with skin tags. Indian J Dermatol 2009;54:20-2.
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Original Articles
Yazarlar

Melis Gönülal 0000-0003-4496-7769

Kenan Teker Bu kişi benim 0000-0003-2466-7435

Yayımlanma Tarihi 30 Haziran 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 3 Sayı: 2

Kaynak Göster

Vancouver Gönülal M, Teker K. The role of impaired glucose and lipid metabolism and liver enzyme abnormalities in the formation of multiple acrochordons: a case-control study. Mucosa. 2020;3(2):42-51.